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Updated: Oct 22, 2025
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Closure of a Patent Foramen Ovale PFO: An Intervention Sequence
Published on: December 23, 2022
4.1K
Patent foramen ovale-When to close and how?
Aurel Maloku1, Ali Hamadanchi1, Marcus Franz1
1Department of Internal Medicine I, Cardiology, Angiology, Intensive Medical Care, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany.
Herz
|August 31, 2021
Summary
Patent foramen ovale (PFO) closure effectively reduces stroke risk in select patients. Interventional PFO closure is a recommended treatment for cryptogenic stroke, with a low number needed to treat to prevent recurrence.
Area of Science:
- Cardiology
- Neurology
- Interventional Cardiology
Background:
- Patent foramen ovale (PFO) is a common cardiac anomaly.
- Cryptogenic/cardioembolic stroke in patients aged 16-60 with high-risk PFO warrants specific treatment strategies.
Purpose of the Study:
- To evaluate the efficacy and safety of interventional PFO closure for stroke prevention.
- To analyze the number needed to treat (NNT) for PFO closure in reducing stroke events.
Main Methods:
- Review of current guidelines recommending PFO closure (Class A, Level I evidence).
- Discussion of interventional PFO closure using double-disk occlusion devices and antiplatelet therapy.
- Analysis of NNT data from key trials (RESPECT, CLOSE, REDUCE).
Main Results:
- PFO closure is recommended for specific patient groups post-stroke.
- NNT to prevent one stroke varies by trial and follow-up duration (e.g., 20 in CLOSE, 18 at 10 years).
- The procedure is relatively easy to learn but requires careful execution to minimize complications.
Conclusions:
- Interventional PFO closure is an effective strategy for preventing recurrent stroke in appropriate patients.
- Individualized treatment decisions are crucial, especially for conditions beyond stroke like migraine, due to limited evidence.
- Longer follow-up durations can reduce the NNT, highlighting the long-term benefits of PFO closure.
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